You will need to sign on with your LLLID (La Leche League ID) before you can post. If you have never claimed your LLLID, create your LLLID now. To sign in, click the LLLID Sign On button in the upper right corner. Enter your LLLID Alias and click the button again.

16 month old, slow weight gain. Any advice??

My daughter was EBF and slow to start solids. I'm sure some of you will remember us on here... I posted questions all the time!! She did not show much interest in solids until 10 months and then she really took off around 12 months. She was on BM until 14 months old and I slowly incorporated and transitioned her over to cow's milk. She has always been somewhat "petite" or small. She was in the 35 percentile for most of her dr visits and the dr said that was OK. She had a wellness visit at 13 months and was 19 lbs. Then... her last wellness was at 16 months, and that was about 2-3 weeks ago... she was still 19 lbs!!!! I was surprised to see that she had not gained ANY weight. The doctor asked how she was eating and I told her she was getting better about table foods and feeding herself, but sometimes she'll get tired of chomping with her gums (only has top two teeth!!) and wants stage 3 foods again. I also had been adding an ounce or two of water to her whole milk b/c she showed signs of constipation. I started adding prunes to her breakfasts, and that issue has been fine now. The doctor told me to stop the water to milk and only give her whole milk. She also said to stop any fruit juices, that they were empty calories, and give her some Pediasure to see if that would help with the weight gain. The doctor didn't seem concerned with her solids that she was eating... just said to keep at it, etc.

The doctor did tell me that if she still had not gained weight at her 19 month appointment (which is the end of October) or that if her weight drops off... that we would need to start looking at "why" that is happening. Now she has never "lost" weight... but why isn't she "gaining"??? And should I be terribly concerned? The dr said her hemoglobin, iron, etc has always looked good, but they would need to consider doing some tests to see what is possibly going on?

So, I have started adding some Pediasure during the day, giving whole milk (with no water added), I do give water or juice only during meals, and I push any foods her way that she will eat (whether finger foods, table food, or stage 3 foods).

Have any of you had any experience with this? I'm worried now feeling like something might be "wrong" with her b/c she is still such a lightweight. The doctor did tell me, "she might always be petite, and that is fine, but we just need to see how she is the next few months until next appt". My husband and mother are telling me not to worry... that she is happy, healthy, eats well and has always been on the small side... but I'm petrified that by the next appt she'll not have gained weight!!!

Re: 16 month old, slow weight gain. Any advice??

I haven't personally had experience with a slow-to-gain toddler, but I still think I can answer some of your questions, based on what I have read here, posted by moms who have had issues with their kids being tiny or slow to grow.

The first thing to check is the scale. Using different scales at different well-baby visits can really throw off where your child falls on the chart, and whether that makes growth appear normal, or not. Even in the second year, children should be weighed on the same scale every time and in the nude- particularly if they are petite.

Second thing to think about is her growth in height and head circumference. If she is continuing to grow along a reasonable trajectory in those dimensions, it's a good indicator that she's getting enough to eat and is growing at her own, unique trajectory, and is just going through a pause in her weight gain. Growth isn't perfectly smooth in all dimensions, after all- it's pretty normal for kids to pause in height and shoot up in weight, or to pause in weight while growing significantly taller.

It's also normal for the rate of weight gain to slow waaaay down in the second year. Kids grow fastest in infancy and then slow down in toddlerhood. For example, my kids gained around 10 lbs in their first 4-6 months, but didn't gain another 10 lbs until around 18 months, and their third 10 lb increment took at least another year, probably more- and my kids are off the charts for height and on the high side for weight.

Your baby has always been petite, and that's a good indicator that her weight is normal. But your doc's course of action makes sense to me- take a wait-and-see approach for now, while focusing on her diet and trying to get her to eat some more high-calorie solids. If her weight gain doesn't pick up in a few months, maybe consider some tests to rule out possible non-normal explanations for slow growth- I think you'd be looking at some hormone tests and maybe some allergy tests, as well. Nothing too invasive or crazy.

Pediasure is one way to get calories into a toddler, but there are other, arguably healthier alternatives- like adding olive oil or butter to her low cal solids (e.g. veggies, cereals, and fruits), or just giving her some ice cream!

Re: 16 month old, slow weight gain. Any advice??

Thanks for the response! I will definitely try adding olive oil or butter to her low cal solids. She loves things like peas, carrots, sweet potatoes... and hasn't like things like avocado yet, but I should try again just in case she will like them and can get those good "fats" in. I have been incorporating the Pediasure, but would definitely like a healthier alternative!

She HAS been growing at a reasonable rate for height and head circumference.... I believe the weight was the only thing that had "plateaud" (sp?). It was a straight line showing no increase or decrease in curve.

Getting her to eat has been a challenge and especially lately (last two weeks). She was sick for the very first time and it quickly turned into bronchitis. The dr put her on a 10 day antibiotic and her appetite has been lower lately. The dr did mention not to worry too bad during this time... that with her being sick, it was just important to get her healthy and get through this time. Now that she is back to 100%... I'm trying to pack her full of food (I feel like that's what I'm doing anyway). I try to feed her toddler meals and after awhile, she just gets tired of them and tries to spit out the noodles or meat or whatever. So then I resort to finishing her meal with yogurt or a nutrigrain bar or a stage 3 food or something similar. I HAVE to figure out a way to get this toddler to eat more of real foods!!!!

Re: 16 month old, slow weight gain. Any advice??

Seeing a plateau in weight gain is normal for a toddler, it really is. I know that the growth charts make it look like growth always occurs as a smooth, upward progression- but that's a statistical artifact created by merging the more jagged-looking curves of a large population of babies. As long as weight and head circumference continue to grow, you know that growth is continuing.

Don't be sad about having a smaller kid. Believe me, it's not a bad thing. I know that it gets you a lot of flack and worry from the pediatricians when your LO is a toddler, but as you get into the childhood years you're going to get nothing but high fives for "saving" your kid from the epidemic of childhood obesity.

Is your LO averse to chunky or textured foods? A lot of kids have aversions to particular textures, so IMO you shouldn't feel bad about offering more puréed foods. Does she like yogurt or mashed or pureed beans? Those are both good high-cal solids for kids with texture issues.

Re: 16 month old, slow weight gain. Any advice??

I think you may be getting overly concerned, which is understandable. But trying to pack a child full of food may backfire.

Your child grew between appointments, just did not gain weight. There is probably nothing alarming about this. Your doctor is not alarmed, if he or she were, they would be trying to find out "why" your baby is not gaining NOW, not 3 months from now.

There is a very good book aimed at parents who are concerned about their children's weight gain and eating habits, called "My Child Won't Eat," by Carlos Gonzalez. It is not about how to get your child to eat, rather, it explains why, in most cases, these concerns are unfounded or overstated. It contains a good explanation of charting and what charts mean and do not mean.

If you are still concerned after reading that book, then I would suggest, trust your mama instincts. Sometimes slow growth does indicate a medical issue.